BIOMECH Exam 1

What refers to the evaluation and intervention that focuses on ROM, strength, endurance, and preventing contractures and deformities?

Biomechanical Frame of Reference

The Biomechanical Frame of Reference focuses on ____________, _________________, and _________________.

ROM, strength, and endurance

The Biomechanical Frame of Reference prevent _________________ and _________________.

contractures; deformities

What are the 5 key purposes of the Biomechanical Frame of Reference?

improve ROM

increase strength

increase endurance

restore function

reduce deformity

What are the three domains of the Biomechanical Frame of Reference?

range of motion

strength

endurance

What refers to the ability of a joint to move?

ROM

What are the four types of ROM?

active range of motion

active assistive range of motion

self range of motion

passive range of motion

What is an example of active range of motion?

actively moving arms in the air

What is an example of active assistive range of motion?

patient is doing some of the range of motion, therapist is doing the other part

What is an example of self range of motion?

patient is doing the range of motion themselves

What is an example of passive range of motion?

therapist is doing all of the range of motion

What factors affect ALL types of ROM?

connective tissue

muscles & tendons

skin

edema

bone

psychological concerns

cognition

pain

What refers to the ability of a muscle to produce tension?

strength

What refers to when the muscle or muscle group maintains a constant length as resistance is applied, and no change in the joint position occurs?

isometric contraction

What refer to when muscle shortens when muscles are actively moving?

isotonic contraction

What factors influence strength?

number and size of muscle fibers

joint ROM

nervous system

pain

psychological

cognition

fatigue

What refers to the ability to sustain muscle activity?

endurance

What are two types of endurance?

muscular endurance

cardiopulmonary endurance

What refers to the ability of a muscle or group of muscles to sustain repeated contractions against a resistance for an extended period of time?

muscular endurance

What is refers to the ability of your heart, lungs, and blood vessels to deliver oxygen to working muscles during sustained physical activity?

cardiopulmonary endurance

What factors influence endurance?

work being done

oxygen supply

medical complications

age

pain

psychological

cognition

fatigue

The Biomechanical Frame of Reference can be used with any clients with impairments/limitations in ____________, _____________, and _____________________.

ROM, strength, and endurance

What are examples of health conditions where the Biomechanical Frame of Reference may be used?

orthopedic disorders

lower motor neuron dysfunction

What are the primary body systems that the Biomechanical Frame of Reference addresses?

musculoskeletal system

nervous system

integumentary system

cardiopulmonary system

What approach does the Biomechanical Frame of Reference use?

REMEDIATION

The Biomechanical Frame of Reference uses REMEDIATION to improve:

___________________________

___________________________

___________________________

ROM

strength

endurance

What are the three main goals of Biomechanical Intervention?

1. restore function

2. prevent further injury

3. compensate for limitations

What goal does prescribing purposeful activities to increase available ROM, strength and endurance through remediation work towards?

restore function

What goal does encouraging functional activity and educating on safety techniques work towards?

preventing further injury

What goal foes modifying the environment, activity, or tools work towards?

compensate for limitations

What is the Overload Principle?

change only occurs when the system performs ABOVE its normal capacity

The Overload Principle acknowledges that the system needs to be ________________________.

STRESSED

After the system is stressed, we need to allow the system to _________________.

ADAPT

To allow the system to adapt, we need to permit _____________________.

adequate rest

What is an example of the Overload Principle?

get to edge of bed --> then do ADLs at EOB --> then walk to sink --> then stand while doing ADLs --> take shower

What are the 7 Biomechanical Domains?

1. structural stability

2. edema

3. ROM

4. muscle strength

5. sensation

6. dexterity

7. endurance

What is structural stability also known as?

PAIN

What needs to be addressed first?

pain (visual analog scale can be used)

What refers to the condition characterized by an excess of watery fluid collecting in the cavities or tissues of the body.?

edema

What are different assessments for edema?

volumeter

figure 8

circumferential

What is an assessment for PROM and AROM?

goniometry

What is an assessment for muscle strength?

Manual Muscle Testing (MMT)

What is an assessment for sensation?

Semmes Weinstein Monofilament

True or False; hypersensitivity AND hyposensitivity makes things uncomfortable for clients

TRUE

What is an assessment for dexterity?

9 hole peg test

True or False; ALL Biomechanical Domains affect dexterity

TRUE

What is an assessment for endurance?

Rating of Perceived Exertion (RPE)

What does the level of exertion on the RPE-BORG reported by the client multiplied by 10 represent?

client's HR

True or False; the 7 Biomechanical Domains (pain, edema, endurance, ROM, dexterity, sensation, and strength) are all interrelated and affect each other.

TRUE

WHY do occupational therapists use ROM assessments?

identify and document motion restrictions that may affect FUNCTIONAL abilities

What are the contraindications for AROM and PROM?

dislocation or fracture

tendon repair

surgery

What are the precautions for AROM and PROM?

inflammation

severe osteoporosis

subluxation

hemophilia

prolonged immobilization

What is WNL?

within normal limits

What is WFL?

within functional limits

What is BNL?

below normal limits

If AROM is WNL/WFL then PROM will .....

also be WNL/WFL

If AROM is limited, what should be completed next?

evaluate PROM to determine reason for limitation

If PROM > AROM then ....

likely due to WEAKNESS

If PROM = AROM then ....

likely due to a STRUCTURAL issue

What is an example of a structural issue that can influence AROM/PROM?

tightened joint capsule

What movement lifts the arm up & over head?

shoulder flexion

What movement lifts the arm out to the side, then over the head?

shoulder abduction

What movement is used to touch the back of the head?

external rotation

What movement is used to touch behind the lower back?

internal rotation

What movement is used to turn the palms up & down?

supination/pronation

What movement bends the wrists up and down?

wrist flexion/extension

What movement makes a fist then opens fingers?

digit flexion/extension

What movement touches the thumb to the digiti minimi?

opposition

When assessing PROM, what does the OT need to respect?

PAIN the client may experience

When assessing PROM, what does the OT need to describe?

the procedure

What bone does the OT support when assessing PROM?

proximal bone

How should the OT move the client when assessing PROM?

SLOWLY in an physiological fashion

What refers to the resistance felt at the END of PROM?

"end feel"

What is a hard "end-feel"?

bone to bone

What is an example of a joint with a hard end-feel?

elbow joint (full extension)

What is a soft "end-feel"?

soft tissue restriction (when fleshy surfaces contact)

What is an example of a joint with a soft end-feel?

knee joint (full flexion calf on thigh)

What is a firm "end-feel"?

significant resistance but slight "give" due to capsules and ligaments

What type of stretch has more "give" than capsular / ligamentous?

muscular stretch

What refers to the hard rebound at the END of a person's ROM, common with spasticity?

springy

What is a empty or no "end-feel"?

due to pain or when client doesn't let you

What tool is used to PRECISELY document range of motion?

goniometry

How should you hold and position the goniometer in relation to the client's body?

hover over their body and do not be handsy

What is the first step in the goniometry procedure?

position client with joint in NEUTRAL position

What is the second step in the goniometry procedure?

place the stationary arm of goniometry parallel to proximal bone

What is the third step in the goniometry procedure?

place the axis of the goniometer over the axis of motion

What is the fourth step in the goniometry procedure?

note zero position

What is the fifth step in the goniometry procedure?

patient perform the movement

What is the sixth step in the goniometry procedure?

reposition goniometer after movement

What is the seventh step in the goniometry procedure?

read scale

What is the eighth step in the goniometry procedure?

measure arc of movement

When do you position the moveable arm of the goniometer?

1. follow extremity with moveable arm

2. keep goniometer in start position until movement is completed

What two movements have no "proximal bone"?

internal/external rotation

pronation/supination

What does the goniometer measure for internal/external rotation and pronation/supination?

rotation of the humerus

How should IR/ER be measured if a client has shoulder ROM limitations?

adduct humerus, elbow flexed to 90 degrees

How many numbers are documented in goniometry?

TWO NUMBERS

What is the first number documented in goniometry?

starting position

The starting number is ____________ if client is in neutral position, or it is ________________ if they cant reach neutral.

zero; positive

What is the second number documented in goniometry?

final position (where motion stopped)

Any _____________ joint is considered ONE measurement.

HINGE